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Psychologically Informed Environment

A Psychologically Informed Environment is consciously designed to take into account the psychological and emotional needs of the people using the service.

It is particularly important where people have complex and entrenched needs or have experienced acute trauma. Some have difficulty managing their emotions, appear impulsive and do not consider the consequences of their actions. Some may be withdrawn, isolated and reluctant to engage or exhibit anti-social behaviour.

The purpose of a PIE is to help staff understand where these behaviours are coming from and therefore work more creatively and constructively with challenging behaviours.

The five elements of a PIE are:

Psychological Framework PIE will use an overarching framework to provide a consistent approach to care. Staff work through the lens of complex trauma to help the residents enact change in their lives and to challenge negative patterns of behaviour.

Environment Shared social spaces are important to help break down any feeling of ‘us and them’. Impromptu chats are given equal importance as formal meetings – staff eat meals and socialise with residents as often as possible. It is often in a more relaxed situation that the best work can be done.

Evidence gathering practice The Mental Health Recovery Star which is a tool to show change and promote further recovery. The star gives equal importance to personal growth (such as increased self-esteem) as to more traditional signs of recovery (such as better budgeting).

Relationships Relationships are seen as the primary tool for change. It is through good relationships and support that staff can help a resident start to make positive changes in their life.

Staff support and training All staff are trained in Trauma Informed Care and Complex Trauma allowing them to be confident in working with often very damaged people. All staff have regular support and supervision sessions to debrief and discuss caseloads.

During 2017 Highwater House, one of St Martins services, adopted a Psychologically Informed Environment (PIE) approach to caring for its residents.

Due to the complex needs of the people who use our service, they will from time to time become verbally and physically aggressive. Highwater House uses ‘elastic tolerance’ to help the resident retain their placement at the home.
Elastic tolerance is a concept that encourages creative and flexible ways to dealing with issues that would normally result in a warning or eviction. The aim is to address disruptive and negative behaviour without re-enforcing the client’s
sense of rejection or abandonment. The home uses temporary bans from the premises when residents become volatile rather than letting behaviours escalate to the point of eviction – this gives the resident time to calm down and reflect before returning to the home without fear of further repercussions.

Since adopting the PIE approach, we have seen a reduction in ‘time-outs’, police callouts and untoward incidents. We will be rolling this out across all our services where appropriate in 2019.